New Membership Application

All information is required, except as noted

"*" indicates required fields

Primary Contact

MM slash DD slash YYYY

Contact Information

For each family member, please provide the following information:
Last Name
First Name
Relationship (spouse/child/nanny)
For each family member, please provide the following information. Use the plus to add more family members.
I hereby apply for membership in the Newfield Swim Club, Inc., together with the above-listed members of my immediate family, who are related to me as described above (including children under the age of 26 years), and who are residing in my household as their actual full-time residence. I understand and agree to the conditions and terms of payment for Membership and Fees indicated in the Newfield By Laws, which may be amended without prior notice to me. Please sign this electronic application by typing in your name in the space provided below. If the BOND is to be issued in the name of two adult family members (e.g., husband and wife), both must sign the Application.
Credit Card
American Express
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Expiration Date